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TRAUMATIC SHOULDER DISLOCATIONS IN PATIENTS OLDER THAN 50 YEARS.



Abstract

Aim: Traumatic shoulder dislocation in patients older than 50 years is an unusual injury with specific anatomic lesions and different treatment considerations than these encountered in younger patients. We present our experience in treating such kind of injuries.

Patients-methods: Between January December 2002 9 patients-4 males, 5 females – with ages ranging between 50–72 years (mean age 64 y.), have been treated in our department suffering from first traumatic shoulder dislocation. Rehabilitation program and overall recovery progress was observed in an outpatient basis while postoperative outcome was evaluated using ASES and UCLA rating scores.

Results: In 4 patients rotator cuff tear was found and reconstructed by suturing the lesion. One (1) of these patients, who had a coexisted bony Bankart lesion, presented 1 ½ month postoperative with recurrence of dislocation. Bony Bankart lesion prevented reduction in 2 patients and was reconstructed using open stabilization in one and arthroscopic to the other. HAGL lesion was detected in another patient and treated with open reduction and shoulder stabilization. Finally 2 patients with shoulder dislocation and coexisted greater tuberosity fracture were treated with closed reduction.

Conclusions: Ttraumatic shoulder dislocation in patients older than 50 years consists a distinct entity which if inadequately treated leaves the shoulder with severe functional impairment. Recurrent shoulder dislocation is an unusual complication in such patients but on the other hand rotator cuff tears and glenoid bony lesions are frequently encountered necessitating treatment. Postoperative patients should be examined in small intervals with a high degree of suspicion for the above mentioned coexisted lesions.

The abstracts were prepared by Eleni Koutsoukou. Correspondence should be addressed to him at the Hellenic Association of Orthopaedic Surgery and Traumatology (HAOST), 20, A. Fleming str, 15123 Marousi, Athens, Greece.